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Death of diabetic Castledawson teenager led to new guidelines

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A Castledawson teenager who was admitted to Antrim Area Hospital suffering from a diabetic condition died after being treated using adult guidelines, an inquest has heard.

Coroner Suzanne Anderson was also told how staff failed to take appropriate action when it became apparent that the condition of 15-year-old Shauna Shivers, from Castledawson, was deteriorating.

On November 26, 2009, Shauna had been correctly diagnosed by her GP as requiring hospital treatment for diabetic keto-acidosis – a dangerous complication caused by a lack of insulin in the body most common in children and young adults suffering from Type 1 diabetes.

Shauna was admitted to an adult ward and received treatment, including a quantity of intravenous (IV) fluids, in line with adult protocols. Her blood glucose levels dropped significantly and Shauna also developed a swelling on the brain (cerebral oedema) which proved fatal.

Consultant paediatrician Paul Jackson compiled a report for the coroner. At yesterday’s hearing in Belfast, he said the amount of IV fluid given to a patient was crucial, given differing metabolisms.

“There are definite guidelines depending on whether you are an adult or a child,” he said.

Although Dr Jackson said the amount of fluid administered “exceeded both the adult and paediatric protocols”, he could not say for certain if it led to Shauna’s death.

“I think it is possible, and maybe even likely, that it is a factor in the causation of cerebral oedema,” he said.

However, Dr Jackson added that cerebral oedema “still could have been a complication even without the excess fluids”.

The coroner was also told that an early CT scan would have been helpful once Shauna’s condition was noticed to have deteriorated.

Interim Medical Director for the Antrim Area Hospital, Dr Gregory Furness, gave evidence that the lessons learned from Shauna’s death had resulted in new Province-wide guidelines on the treatment of young people.

In her conclusions, the coroner said that the swelling on the brain “was not recognised by the medical staff. She continued to deteriorate.”

Ms Anderson found that Shauna died on December 3, 2009 due to the development of cerebral oedema.

Expressing her sympathy to Shauna’s parents, Margaret and Bernard, the coroner said she hoped they took some comfort from the Northern Trust’s new treatment protocols and that “no other family will have to endure what you have had to”.

Mr and Mrs Shivers afterwards declined to comment.

 

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